SARS-CoV-2 incidence among teaching staff in primary and secondary schools-Wales, 2020-2021.

BACKGROUND: During the COVID-19 pandemic, face-to-face delivery of education in schools across Wales was disrupted with repeated school closures to limit risk of infection. Evidence describing the incidence of infection amongst school staff during times when schools were open is limited. A previous research study found infection rates were higher in English primary school settings when compared with secondary. An Italian study suggested teachers weren't at greater risk of infection in comparison to the general population. The aim of this study was to identify whether educational staff had higher incidence rates than their counterparts in the general population in Wales, and secondly whether incidence rates amongst staff differed between primary and secondary school settings and by teacher age. METHODS: We performed a retrospective observational cohort study using the national case detection and contact tracing system implemented during the COVID pandemic. Age stratified person-day COVID-19 incidence rates amongst teaching staff linked to primary or secondary schools in Wales were calculated for the autumn and summer terms during 2020-2021. RESULTS: The observed pooled COVID-19 incidence rates for staff across both terms was 23.30 per 100,000 person days (95% CI: 22.31-24.33). By comparison, the rate in the general population aged 19-65, was 21.68 per 100,000 person days (95%: CI 21.53-21.84). Incidence among teaching staff was highest in the two youngest age groups (< 25 years and 25-29 years). When compared to the age matched general population, incidence was higher in the autumn term amongst primary school teachers aged ≤ 39 years, and in the summer term higher only in the primary school teachers aged < 25 years. CONCLUSION: The data were consistent with an elevated risk of COVID-19 amongst younger teaching staff in primary schools when compared to the general population, however differences in case ascertainment couldn't be excluded as a possible reason for this. Rate differences by age group in teaching staff mirrored those in the general population. The risk in older teachers (≥ 50 years) in both settings was the same or lower than in the general population. Amongst all age groups of teachers maintaining the key risk mitigations within periods of COVID transmission remain important.

Tweenager Computer Visual Syndrome Due to Tablets and Laptops during the Postlockdown COVID-19 Pandemic and the Influence on the Binocular and Accommodative System.

The aim of our study was to compare computer visual syndrome (CVS) in a tweenager student population who use tablets and laptops only to play versus CVS in tweenagers who use these digital devices at school to study, in addition to playing. The tests performed were a validated survey for children for the detection of CVS and accommodative and vergence tests. The CVS item questionnaire was divided into four main groups based on questions concerning the following: (I) the digital device usage time, (II) musculoskeletal and ergonomic nature, (III) visual symptoms, and (IV) ocular surface symptoms. The high-demand digital device group showed worse punctuation in all item groups. From the optometric perspective, when the subjects were classified according to the CVS, high-demand participants presented a clear tendency to exophoria with statistically significant differences in distance vision (-1.94 ± 4.48 Δ) and near vision (-5.78 ± 8.62 Δ) (p < 0.01). Our results establish a relationship between the increased use of electronic devices and computer vision syndrome in the preadolescent population. In addition, this situation is related to the presence of visual, accommodative, and binocular dysfunctions that could affect the efficiency of the visual system.

Proctologic emergency consultation during COVID-19: Comparative cross-sectional cohort study.

INTRODUCTION: Proctologic issues entail a frequent reason for consultation in the emergency department (ED). We aim to analyze how the SARS-COV-2 pandemic has impacted in the demand for proctological consultations. MATERIAL AND METHOD: Descriptive comparative retrospective study of cross-sectional cohorts of patients attending the ED for proctological complaints from March to April in 2020 and 2019. Demographic variables, comorbidities, reasons for consultation and diagnosis, treatment and readmission were included. Four periods were analyzed according to the different stages of the pandemic derived limitations. RESULTS: A total of 191 patients were reviewed, 58 in 2020 and 133 in 2019 with an average age of 48 years (SD 20.1) and 112 (58.6%) males. The average number of daily consultations was 2.18 patients in 2019 versus 0.95 in 2020 (p=0.025) meaning a 56% reduction in consultations for proctological reasons. This difference in average consultations was significant in both periods of lockout (p=0.001) and previous de-escalation (p=0.014). The diagnosis distribution was similar between both periods; however, perianal abscesses doubled their rate in 2020, 22.4% versus 11.3% (p=0.045). There was an increasing need for surgery, 31% vs 15% (p=0.011) with no difference in outpatients regimen after emergency surgery (12.5% vs 7.5%, p=0.201). Three patients in 2020 required readmission to the ED (5.2% vs 12.9%, p=0.086). CONCLUSION: There was a decrease of a 56% in proctologic emergency consultation, however, the need for surgery was twice more frequent during the study period. Reflection on the use of emergencies for proctological reasons is warranted.

Impact of COVID-19 Pandemic on Anesthesia and Critical Care Residents in Spain.

BACKGROUND: The pandemic caused by coronavirus disease 2019 (COVID-19) has substantially changed the activity in Spanish healthcare centers. Residents who face pandemics are vulnerable physicians with different knowledge and experience. OBJECTIVES: This study aimed to determine the impact of COVID-19 pandemic on the Anesthesia and Critical Care residents and to establish its formative and personal consequences. METHODS: A 35-question digital survey was developed, and was distributed among Anesthesia and Critical Care residents in Spain. The quantitative variable "Objective Formative Impact Score" (PIOF) was defined, being proportional to the impact on formative routines. RESULTS: Several parameters were associated to a higher formative impact, such as the exposition to patients with COVID-19 (P = 0,020), an increase in the autonomy (P = 0,001), fear to contagion due to lack of protective equipment (P = 0,003), working in higher incidence areas (P < 0,001), being assigned to COVID-19 critical care units (P < 0,001), or to other departments different from Anesthesia and Critical Care. Residents experienced feelings of loneliness from the social distancing or ethical conflicts when working in suboptimal conditions. CONCLUSIONS: COVID-19 pandemic has had a major impact on Anesthesia and Critical Care residents both personally and formatively. The designed parameter PIOF brings an objective value about residents' formation.

Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cross-Sectional Study.

BACKGROUND: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists' work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. MATERIAL AND METHODS: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. RESULTS: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). CONCLUSIONS: Dental hygienists' return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors.

Patients' Perceived Satisfaction Through Telephone-Assisted Tele-Consultation During the SARS-CoV-2 Pandemic Period: Observational Single-Centre Study at a Tertiary-Referral Colorectal Surgery Department.

Introduction: The pandemic produced by SARS-CoV-2 has obliged us to set up the tele-assistance to offer a continuity of care. This implies an innovation, being the degree of satisfaction of patients unknown. Methods: A telephonic survey was conducted with the validated in the Spanish tool Telehealth Usability Questionnaire (Telehealth Usability Questionnaire; rating from 1-7) of all candidate patients assisted consecutively in the Coloproctology Unit. We included demographic variables, education level, job status, diagnosis and consultation type. A descriptive study was done. The relationship between the willingness of consultation model in the future (telemedicine vs traditional) and the categorical variables was analysed through the chi-squared test. Results: A total of 115 patients were included. The average age was 59.9 years, being 60% women. The average score in each of the survey items was higher than 6 in all the questions but 1. 26.1% of the surveyed patients confessed being advocated to tele-assistance in the future. The only factors related to greater willingness to tele-assistance were male gender (37% vs 18.8%; P = .03) and a higher academic preparation level in favour of higher technical studies (35.9%) and university studies (32.4%) opposite to the rest (P = .043). The rest of variables studied, job status, labour regimen, diagnostic group and consultation type did not show any relationship. Conclusions: A vast majority of patients answered favourably to almost all the items of the survey. However, only 26.1% of them would choose a model of tele-assistance without restrictions.

A Regional Geography Approach to Understanding the Environmental Changes as a Consequence of the COVID-19 Lockdown in Highly Populated Spanish Cities

Spain has been highly impacted by the COVID-19 pandemic, which is reflected at different scales. From an economic point of view, lockdowns and the reduction of activities have damaged the country (e.g., complete lockdown from March 13 to June 21, 2020). However, it is not clear if the associated environmental impacts could be observed in 2020. Currently, studies on the effects of the lockdown (e.g., decrease in economic activities, transport and social communication) on specific parameters related to climate change, such as air temperature or air pollution, due to a drastic decrease in human activities are rare. They are focused on specific cities and short periods of time. Therefore, the main goal of our research will be to assess the records of air temperature and air quality during the whole of 2020 compared to references from previous years (30 years for air temperature and 10 for air quality). We paid attention to the possible effects of the reduction of activities (e.g., tourism and transport) in March, April and May and the different restrictions of each lockdown in Spain. To achieve this goal, five urban climate stations with long-term time series within the most populated cities of Spain were analyzed (Barcelona, Madrid, Málaga, Sevilla and Valencia). We conclude that it is possible to affirm that the impacts of the COVID-19 pandemic on the atmospheric conditions in 2020 are not clear and not strictly focused on the lockdown or reduction of activities in these urban areas. No evidence of a reduction in the annual air temperature was found, and only a minimum reduction of rates of pollutants was registered in the highly populated cities of Spain. Therefore, it is worth confirming that these changes could be affected by other factors, but on a global scale and not directly due to the COVID-19 pandemic. Considering recent studies on the relationships between air pollutants, temperature and the spreadability of COVID-19, green policies must be further imposed in urban cities, since temperatures do not stop increasing year by year.

Recommendations by the Spanish Society of Epidemiology and Oral Public Health (SESPO) for the healthcare adaptation of public health dental clinics in Spain during the COVID-19 pandemic.

BACKGROUND: In March 2020, the World Health Organization (WHO) declared the COVID-19 pandemic and, a few days later, the Spanish Government declared a State of Emergency and the population lockdown. This crisis situation crisis forced deep changes in health care. At dental care level, it became necessary for both public health services and private consultations to plan changes to enable them to face this healthcare challenge. MATERIAL AND METHODS: SESPO and the General Council of Dentists of Spain (CGDE) appointed a Working Group to prepare a protocol for dental clinics after the lockdown stage. Continuing with this teamwork task, a series of recommendations addressed to public health managers and the dental workforce were agreed, according to the COVID-19 protection protocols, with the evidence available at the time of their preparation. RESULTS: The SESPO Working Group prepared a schedule with recommendations to be taken. The CGDE presented this document to the Ministry of Health, Consumption and Social Welfare, and SESPO emailed it to all the Health Councils of the autonomous regions. The document was also uploaded to the CGDE and SESPO websites and was emailed to all SESPO associated members. CONCLUSIONS: Keeping in mind the existing territorial variation, both at the organization level of dental public health services, and at the care level (especially in child preventive programs and care for pregnant women), this health crisis has highlighted the importance of teamwork. It is necessary to unify the standards for all dental health care units in the national territory in challenging times. Key words:COVID-19, Dental public health, dental care, dentistry, primary care, infection, SARS-CoV-2.

Price Fluctuation, Protected Geographical Indications and Employment in the Spanish Small Ruminant Sector during the COVID-19 Crisis.

Official milk prices in the Spanish small ruminant sector were used for 5 years (2015-2019) to analyze the effect caused by the coronavirus disease (COVID-19) crisis in 2020. Meat price fluctuations were also studied using the weekly prices officially provided by some of the main agrarian markets of the country (n = 6) in 2019 and 2020. Moreover, the sales and prices of three protected geographical indications (PGI) of lamb meat served to study the marketability when the products are sold or not under these quality labels in a crisis context. According to Spanish Government's official communications, 2020 was divided in three periods of study (pre-COVID-19, total confinement and post-confinement). The evolution of employment in this subsector in 2020, as a direct consequence of this crisis, was also analyzed considering data provided by producers. Results showed an intra-annual seasonal effect for milk prices in 2020 for both livestock species, as observed in previous years. However, a negative economic impact on goat milk prices due to the pandemic was checked during the confinement and post-confinement months. Sheep milk prices remained stable. Lamb and goat kid meat prices showed a similar trend in comparison with 2019 during the pre-COVID-19 period. The total confinement period recorded a short interval of 1-2 weeks in which the prices declined, before the suspension of quotations in many markets. In contrast, once confinement was completed, meat prices for both ruminant species rapidly reached levels that existed before the coronavirus crisis. Overall data suggested the protective effect of the PGI marks on lamb meat. Lambs with a PGI had better 2020 prices than non-PGI lambs (+8%), regardless of the period analyzed. Moreover, with fewer lambs sold in 2020, there was a relevant drop in sales of non-PGI lambs vs. PGI (-19% vs. -2%) during the first 7 months. Finally, there was little or no readjustment of the workforce in the small ruminant flocks.

Proctologic emergency consultation during COVID-19: Comparative cross-sectional cohort study.

INTRODUCTION: Proctologic issues entail a frequent reason for consultation in the emergency department (ED). We aim to analyze how the SARS-COV-2 pandemic has impacted in the demand for proctological consultations. MATERIAL AND METHOD: Descriptive comparative retrospective study of cross-sectional cohorts of patients attending the ED for proctological complaints from March to April in 2020 and 2019. Demographic variables, comorbidities, reasons for consultation and diagnosis, treatment and readmission were included. Four periods were analyzed according to the different stages of the pandemic derived limitations. RESULTS: A total of 191 patients were reviewed, 58 in 2020 and 133 in 2019 with an average age of 48 years (SD 20.1) and 112 (58.6%) males. The average number of daily consultations was 2.18 patients in 2019 versus 0.95 in 2020 (p=0.025) meaning a 56% reduction in consultations for proctological reasons. This difference in average consultations was significant in both periods of lockout (p=0.001) and previous de-escalation (p=0.014). The diagnosis distribution was similar between both periods; however, perianal abscesses doubled their rate in 2020, 22.4% versus 11.3% (p=0.045). There was an increasing need for surgery, 31% vs 15% (p=0.011) with no difference in outpatients regimen after emergency surgery (12.5% vs 7.5%, p=0.201). Three patients in 2020 required readmission to the ED (5.2% vs 12.9%, p=0.086). CONCLUSION: There was a decrease of a 56% in proctologic emergency consultation, however, the need for surgery was twice more frequent during the study period. Reflection on the use of emergencies for proctological reasons is warranted.